Local experience with oral probiotics in the prevention of necrotizing enterocolitis in premature babies in a Neonatal Intensive Care Unit

Probiotics are live microorganisms that survive in the gastrointestinal tract and confer beneficial effects on the host when administered in adequate amounts. An important rationale for the use of probiotics in neonates at risk for NEC is the observation that the VLBW infants have aberrant fecal colonization when compared with Abstract Objective: To study the effectiveness and safety of oral probiotics in the prevention of necrotizing enterocolitis (NEC) in breast-fed low birth weight infants. Design: Prospective non-randomized open trial. Setting: Neonatal Intensive Care Unit (NICU) of a local hospital. Patients: All premature neonates admitted to the NICU with birth weight below 2kg and gestation less than 36 weeks. Interventions: Subjects were fed with Infloran Berna (a probiotic preparation containing Lactobacillus acidophilus and Bifidobacterium infantis) with breast milk after the first week of life until discharge. The results were analyzed and compared against matched controls selected from admissions to NICU during the same study period. Main outcome measures: Incidence of NEC. Results: 8 patients were recruited into the intervention arm and matched against 8 control subjects. One patient on probiotics developed NEC and died on day 11. No other patients developed NEC or had other side effects such as gastrointestinal intolerance, diarrhoea or septicaemia. Conclusion: Further studies are needed to investigate the safety and efficacy of probiotics in the prevention of NEC in preterm neonates.